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Purpose: Lung cancer is the leading cause of cancer-related deaths worldwide. However, with the optimization of screening strategies and advances in treatment, mortality has been decreasing in recent years. In this study, we describe non-small cell lung cancer patients diagnosed between 2021 and 2022 at a high-complexity hospital in Latin America, as well as the immunohistochemistry techniques used to screen for ROS1 rearrangements, in the context of the recent approval of crizotinib for the treatment of ROS1 rearrangements in non-small cell lung cancer in Colombia. Methods: A descriptive cross-sectional study was conducted. Sociodemographic, clinical, and molecular pathology information from non-small cell lung cancer individuals who underwent immunohistochemistry to detect ROS1 rearrangements between 2021 and 2022 at Fundación Valle del Lili (Cali, Colombia) was recorded. The clinical outcomes of confirmed ROS1 rearrangements in non-small cell lung cancer patients were reported. Results: One hundred and thirty-six patients with non-small cell lung cancer were included. The median age at diagnosis was 69.8 years (interquartile range 61.9-77.7). At diagnosis, 69.8% (n = 95) were at stage IV. ROS1 immunohistochemistry was performed using the monoclonal D4D6 antibody clone in 54.4% (n = 74) of the cases, while 45.6% (n = 62) were done with the monoclonal SP384 antibody clone. Two patients were confirmed to have ROS1 rearrangements in non-small cell lung cancer using next-generation sequencing and received crizotinib. On follow-up at months 5.3 and 7.0, one patient had a partial response, and the other had oligo-progression, respectively. Conclusion: Screening for ROS1 rearrangements in non-small cell lung cancer is imperative, as multiple prospective studies have shown improved clinical outcomes with tyrosine kinase inhibitors. Given the recent approval of crizotinib in Colombia, public health policies must be oriented toward early detection of driver mutations and prompt treatment. Additionally, future approvals of newly tested tyrosine kinase inhibitors should be anticipated.

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Resumen Introducción. Una cuarta parte de los suelos agrícolas del mundo padece algún grado de deterioro, especialmente por factores antrópicos, no obstante, reducir el daño es posible cuando se desarrollan prácticas adecuadas de producción. Objetivo. Evaluar la efectividad de prácticas agroecológicas de conservación de suelos de ladera en el municipio de Guasca - Cundinamarca. Materiales y métodos. Se establecieron cuatro tratamientos: barreras vivas, barreras muertas, zanjas de infiltración, terrazas y un testigo, por cada tratamiento se realizaron 4 repeticiones, para un total de 20 unidades experimentales (UE). Se establecieron cultivos asociados de arveja (Pisum sativum), fríjol (Phaseolus vulgaris) y zanahoria (Daucus carota), en surcos en contrapendiente, obteniendo 6 surcos por UE. En cada UE se instaló una zanja recubierta con polietileno, con el objetivo de conducir el volumen de agua escurrido y los sólidos arrastrados al recipiente colector final. Del volumen obtenido, después de una respectiva homogenización con un agitador manual, se obtuvieron muestras de 200 ml para posteriormente secarlas y pesarlas en laboratorio. Resultados. Las pérdidas de suelo y agua por escorrentía presentaron un comportamiento variable, lo que puede ser atribuido a la interacción entre la intensidad y frecuencia de las precipitaciones, textura de suelo, manejo histórico del suelo y la variedad de prácticas de conservación empleadas. Conclusión. Todas las prácticas de conservación de suelos implementadas contribuyeron a reducir la pérdida de sedimentos, siendo las zanjas de infiltración la mejor práctica de conservación, presentando una reducción del 87,8 % de las pérdidas frente al testigo.

Abstract Introduction. A quarter of the world's agricultural soils suffer some degree of deterioration, especially due to anthropic factors. However, regeneration of soils is possible when conservation strategies are developed. Objective. Evaluate the effectiveness of soil conservation agroecological practices in the retention of hillside soils in the municipality of Guasca-Cundinamarca. Materials and methods. Four treatments were established: live barriers, dead barriers, infiltration ditches, terraces and a control. For each treatment, four repetitions were performed, for a total of 20 experimental units (EU). Pea (Pisum sativum), bean (Phaseolus vulgaris) and carrot (Daucus carota) crops were established in furrows in counter-slope, obtaining 6 furrows per EU. In each EU a ditch covered with polyethylene was installed, with the aim of driving the volume of drained water and the solids dragged towards a final collector vessel. From the volume obtained, after a respective homogenization with a manual agitator, samples of 200 ml were obtained for subsequent drying and weighing in the laboratory. Results. The losses of soil and water by runoff presented a variable behavior, which can be attributed to the interaction among factors such as intensity and frequency of rainfall, soil texture, historical soil management and the variety of conservation practices used. Conclusion. All the soil conservation practices implemented contributed to reduce the loss of sediments, infiltration ditches being the best conservation practice, presenting an 87.8 % reduction in losses compared with the control.

Resumo Introdução. Uma quarta parte dos solos agrícolas do mundo padece algum grau de deterioro, especialmente por fatores antrópicos, não obstante, reduzir o dano é possível quando se desenvolvem práticas adequadas de produção. Objetivo. Avaliar a efetividade das práticas agroecológicas de conservação dos solos de ladeira no município de Guasca - Cundinamarca. Materiais e métodos. Estabeleceram-se quatro tratamentos: barreiras vivas, barreiras mortas, trincheiras de infiltração, terraços e um controle, por cada tratamento realizaram-se 4 repetições, para um total de 20 unidades experimentais (UE). Estabeleceram-se culturas associadas de ervilha (Pisum sativum), feijão (Phaseolus vulgaris) e cenoura (Daucus carota), em sulcos em contra pendente, obtendo 6 sulcos por UE. Em cada UE instalou-se uma trincheira recoberta com polietileno, com o objetivo de conduzir o volume de água escorrido e os sólidos arrastrados ao recipiente coletor final. Do volume obtido, despois de uma respetiva homogeneização com um agitador manual, obtiveram-se amostras de 200 ml para posteriormente serem secadas e pesadas no laboratório. Resultados. As perdas do solo e água pelo escorrimento apresentaram um comportamento variável, o que pode ser atribuído à interação entre a intensidade e a frequência das precipitações, textura de solo, manejo histórico do solo e a variedade das práticas de conservação empregadas. Conclusão. Todas as práticas de conservação de solos implementadas contribuíram a reduzir a perda de sedimentos, sendo as trincheiras de infiltração a melhor prática de conservação, apresentando uma redução do 87,8 % das perdas frente ao controle.

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La variabilidad climática constituye en la actualidad uno de los principales factores de riesgo para la agricultura y la seguridad alimentaria mundial. Los ecosistemas más vulnerables en Colombia son los que se ubican en la zona alto-andina donde miles de familias campesinas se dedican a la agricultura en pequeña escala. Los programas enfocados a adaptar la agricultura a la variabilidad climática no se apoyan suficientemente en el conocimiento local ni motivan a las comunidades para la acción. Esta investigación propuso un análisis de la relación entre sustentabilidad y adaptación a la variabilidad climática, reconociendo de manera participativa los principales factores de riesgo para la sustentabilidad de la agricultura a partir de indicadores y analizando la efectividad de planes de mejora en la capacidad adaptativa de la agricultura alto-andina. Se desarrolló como un estudio de caso con 13 productores familiares vinculados a la Asociación Red Agroecológica Campesina de Subachoque, en 3 fases: a) creación de un marco de análisis sobre los principales factores de riesgo para la agricultura; b) evaluación de la sustentabilidad a partir de indicadores propios y c) implementación de planes para aumentar la capacidad adaptativa de la agricultura. La evaluación realizada en dos momentos diferentes demostró mejora en los 9 indicadores generados, de forma que la implementación de las acciones para mejorar la sustentabilidad influyeron positivamente sobre la capacidad de las fincas para adaptarse a los riesgos de la variabilidad climática. Las estrategias agroecológicas implementadas mejoraron la resiliencia socioecológica de los agroecosistemas manejados por agricultores familiares, aumentando la posibilidad de que respondan mejor ante cualquier escenario de cambio ambiental.

Climate variability constitutes actually one of the main risks to agriculture and food security in the world. The most vulnerable ecosystems in Colombia are located in the high region of the Andeans where thousands of families farming lives from agriculture in small scale. The programs aimed to adapt the agriculture to climate variability do not take into account the local knowledge; neither motivates communities to action. This research proposed an analysis of the relationship between sustainability and agricultural adaptation to climate variability in a participatory way, recognizing the main risk factors to agriculture sustainability using indicators and analyzing the effectiveness of improving plans to the agricultural adaptation capacity in the high-Andeans. It was developed as a study case with 13 farmers linked to the Agro-ecological Farming Net Association of Subachoque. 3 phases were developed: a) the creation of a framework regarding the main the risks factors to the agriculture; b) sustainability appraisal based on own indicators and c) implementation of plans to increase the agricultural adaptation capacity. The appraisal developed in 2 different moments showed improving in the 9 indicators suggesting that the implementation of actions to the sustainability of farming positively influenced on the farms capacity to face the risks of the climate variability. The agro-ecological strategies implemented, improving the socio-ecological resilience of agro-ecosystems managed by family farmers, increasing the possibility that they better responding to any scenario of environmental change.

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El rol monofuncional de la agricultura empresarial ha generado serios desequilibrios ambientales y socioculturales que comprometen su productividad futura. Una valoración de la multifuncionalidad de la agricultura en 18 sistemas tradicionales, ganaderos y de monocultivos, evaluados en la cuenca del río Guaguarco a partir de variables biofísicas, sociales, culturales, productivas y financieras, calificaron la agricultura tradicional como la más funcional, seguida de los sistemas ganaderos y de monocultivo. La capacidad de los agricultores para desplegar múltiples funciones en sus sistemas de finca constituye una estrategia para enfrentar las adversidades que ponen en riesgo su continuidad.

The monofunctional role of the business-oriented agriculture has generated serious environmental and socio-cultural imbalances that threaten its future productivity. An appraisal of agriculture's multifunctionality in 18 traditional farming systems, livestock farming and monoculture farming, evaluated at the Guaguarco river basin with biophysical, social, cultural, productive and financial variables, evaluated the traditional farming systems as the most functional followed by the livestock farming and monoculture farming. The farmer's capability to deploy multiple functions to their farming systems, constitute a strategy to face the adversities that put at risk continuity.

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Introducción: los antiinflamatorios no esteroideos (AINES) son prescritos con frecuencia en la práctica médica y sus eventos adversos gastrointestinales aumentan la morbimortalidad, la cual puede disminuir utilizando profilácticamente inhibidores de la bomba de protones (IBP), misoprostol o anti H2. Objetivo: estimar la prevalencia de consumo de AINES en una población de consulta externa de Medicina Interna y, en ellos, determinar la frecuencia de prescripción profiláctica de IBP en pacientes con riesgo de sangrado gastrointestinal.Métodos: estudio prospectivo de prevalencia analítica con pacientes mayores de 18 años de la consulta externa de Medicina Interna de la Fundación Hospital San Carlos de Bogotá. Los pacientes consumidores de AINES fueron clasificados en tres grupos de riesgo de sangrado gastrointestinal con base en los factores de riesgo tradicionalmente descritos. Resultados: de 140 pacientes incluidos, el 30% tomaban AINES. El 47,6% (n=20) fueron clasificados en el grupo de bajo riesgo, el 28,5% (n=12) en el grupo de riesgo intermedio y el 23,8% (n=10) en el grupo de alto riesgo. El 47% (20 pacientes) de los que consumían AINES tomaban simultáneamente IBP. Con respecto a los grupos de riesgo, consumían IBP el 80% de alto riesgo, el 50% de riesgo intermedio y el 30% de bajo riesgo. Conclusión: en la población estudiada, la prescripción de IBP en pacientes de alto riesgo es superior a la informada en trabajos internacionales (80% versus menos del 50%). Hay formulación de IBP innecesaria en el 30% de los pacientes de bajo riesgo.

Introduction: Adverse gastrointestinal events related to non-steroid anti-inflammatory drugs (NSAIDs) which are frequently prescribed in medical practice increase morbidity and mortality. These can be reduced through prophylactic use of proton pump inhibitors proton pump (PPIs) or misoprostol anti H2. Objective: The objective of this study was to estimate the prevalence of NSAIDs use in a population of internal medicine outpatients and to determine the frequency of prophylactic prescriptions of PPIs for patients at risk of gastrointestinal bleeding. Methods: This was a prospective and analytical study of prevalence among patients over 18 years of age in the Internal Medicine outpatient service at the Hospital San Carlos in Bogota. Patients who consume NSAIDs were classified into three risk groups based on traditionally described risk factors for gastrointestinal bleeding. Results: Thirty percent of the 140 enrolled patients were taking NSAIDs. 47.6 % (n = 20) were classified in the low risk group, 28.5 % (n = 12) in the intermediate-risk group and 23.8 % (n = 10) in the high risk group. 47% (20 patients) of those taking NSAIDs were simultaneously taking PPIs. Eighty percent of the high risk group, 50% of the intermediate-risk group, and 30% of the low risk group were taking PPIs. Conclusion: PPIs were prescribed more frequently for high risk patients in this study population (80%) than has been that reported in international publications (less than 50%). The prescription of PPIs for 30% of the low risk patients is unnecessary.

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La esquizofrenia en niños es una patología cuyodiagnóstico es difícil. La mayoría de los estudioshablan de síntomas en niños escolares yadolescentes y la continuidad en la que se presentaen los adultos. Sin embargo, siguen existiendovacíos diagnósticos en los niños menoresy se busca encontrar mejores marcadores clínicospara detener o retrasar el deterioro propiode esta patología.

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Se discute el caso de una niña que presentó enuresis y encopresis de manera crónica y como hallazgo principal, las causas de estrés psicosociales derivadas de estas condiciones, así como depresión mayor. El tratamiento aplicado confirma la comorbilidad entre estas patologías y su superposición.

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